OTCohortOccupational therapy international2022

Linking Prioritized Occupational Performance in Patients Undergoing Spasticity-Correcting Upper Limb Surgery to the International Classification of Functioning, Disability, and Health.

Therese Ramström, Johanna Wangdell, Carina Reinholdt and 1 others

PMID 36312840

WHAT IT FOUND

Patients undergoing spasticity surgery prioritized self-care, domestic life, and mobility goals.

Their perceived performance and satisfaction improved significantly at 12 months. However, these subjective gains did not correlate with objective improvements in grip strength or grasp ability.

Key findings

01The most frequently prioritized occupational goals were self-care (41%), domestic life (21%), and mobility (18%).

02Mean COPM performance scores increased by 2.5 points, exceeding the minimal clinically important difference, with no significant differences between subgroups.

03Gains in perceived performance showed little or no correlation with improvements in grasp ability and no significant relationship with grip strength.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study was retrospective and conducted at a single center, which limits generalizability. Therapy providers and assessors were the same individuals, introducing potential bias in outcome ratings. Incomplete follow-up data meant some patients were excluded from analyses. The study did not separate ICF activity and participation components, limiting conclusions about which specific aspects of engagement improved. The individualized nature of COPM goals limits comparability across different populations and settings.

Declared interests

No funding sources or conflicts of interest are explicitly declared in the provided text.

The easy way to misread this

Do not assume that improvements in grip strength or grasp ability will directly translate to better perceived occupational performance. The study found little or no correlation between these objective measures and patient-reported outcomes, suggesting that body-function metrics alone are poor proxies for functional success.

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